Cognition Disorders Flashcards
Depression- Dx
- 2 + weeks, 5+ sx
- Depressed mood, weight, appetite change
- Fatigue, loss of energy
- Thoughts of death
- Impairment in work, love and play
- No bereavement exclusion
Depression- Diff in elders
- Agitation and irritability presenting sx
- Cognitive complaints, but aware of them, lack of effort
- Somatization- diffuse pain fatigue or vague complaints
Depression- Tx
- CBT
- SSRIs
Delirium- Definition
- Transient, organic mental syndrome
- Global impairment of cognitive function
- Acute
Delirium- Eti
- Post-surg, acute mental illness
- Meds, alcohol
- Sleep deprivation
- Dementia (sundowning)
Delirium- Sx
- Alteration in level of consciousness, variable over the day
- Inability to shift attention
- Memory impairment
- Hyper/ hypo active change in behavior
- Sundowning
- Misperceptions, hallucinations, vague delusions
Delirium- Tx
- Tx underlying cause
- Control envt- visual, verbal cues
- Well lit envt- cues for sleep wake cycle
- Neuroleptics- haloperidol
- No anticholinergics or benzos
Dementia- Eti
- Progressive development of 2+ cognitive deficits
- Memory, exec fxn, language, visuospatial, personality
- Interfere with general activities
- Loss of intelligence
Dementia- sx
- Impaired memory, visuospatial and processing speed
- Concrete reasoning intact, abstract impaired
- Agitation
- Agression
- Psychosis
- Depression
Dementia- Dx
- Evidence of significant cognitive decline from previous
- Concern of individual, other
- Deficits interfere with daily activities
- Do no occur exclusively in context of delirium or explained by other mental disorder
Lewy body disease
- Fluctuating cognition with variation in alertness and attention
- Spontaneous parkinksonism
- Vivid hallucinations
- Sleep disorders
- Severe neuroleptic sensitivity
Frontotemporal dementia/ Pick disease- Sx
- Behavioral disinhibition- hoarding, perseverative, stereotyped behavior
- Hyperorality and dietary changes
- Decline in language ability- word creation, word finding, grammar
Depression- Eti
- Prior hx, midst of dementia, delirium
- Deaths, loss of social support & roles
Alzheimers disease
Triad:
- Memory impairment w/ difficulty learning, recalling
- Visuospatial problems
- Language impairment interfere with fxn
- irritability, depression , delusions
Lewy body disease- Eti
- Second most common form of dementia
- Due to abnormal inclusion bodies in brain
Lewy body disease- Tx
Don’t use neuroleptics! Increases parkinsonian sx
Vascular/ multi-infarct dementia- Eti
- Cerebrovascular disease, mini strokes
Vascular/ multi-infarct dementia- Sx
- Dementia sx following stroke
- Gradual onset with mini strokes
- Less severe memory impairment
- Impaired recall, intact recognition
- Difficulty on speeded tests
- More severe depression
Frontotemporal dementia/ Pick disease- Eti
- Younger onset, 50s
- 25% presenile dementias
Frontotemporal dementia/ Pick disease- Dx
- Normal mini-mental exam
- Frontal deficits in verbal fluency, abstraction
Reversible causes of dementia
- B12
- Hematoma, CNS tumor
- Thyroid
- Hypercalcemia
- Alcohol/ drugs
- Heavy metal toxicity
- Depression
Creutzfeld-Jacob- Eti
- Infectious prion disease
- Infectious, sporadic and inherited
- Mad cow, retinal & dura mater transplants
Creutzfeld-Jacob- Sx
- Exaggerated startle response, seizure & extra-pyramidal signs
- Dementia
Creutzfeld-Jacob- Dx
Characteristic EEG patterns, MRI lesions
Dementia- Tx
Chlinesterase inhibitors: Donepezil, Rivastigmine and galantamine
